The development of healthcare Guidelines should be fully open

In a recent post I wrote about the decision by NICE to re-consult on depression guidelines. This late stage development followed on from a briefing from a group of experts who felt the draft guidelines were “not fit for purpose”. This group of experts were “extremely concerned about significant flaws in methodology, lack of transparency and inconsistencies in the document.”

Expert Group that brought sabout a second consultation to NICE guideline on treating depression

Seeking further clarifications on this development I wrote to NICE and received this response: “NICE decided to offer a meeting to the authors of the 17th November letter to discuss their concerns with them. The meeting took place on 27th April. Afterwards, NICE decided to run a second consultation.”

I wrote again to NICE to ask for details of this meeting of the 27th April 2018 with the authors of the “expert briefing” and I was informed by NICE that “the meeting on 27th April was not minuted or otherwise recorded.” Given the call for transparency by this expert group I considered this most disappointing.

I therefore wrote to Professor Sir Simon Wessely as he was one of the authors of the “expert briefing”. [I should say, that I have communicated with Professor Sir Simon Wessely in the past when he was President of the Royal College of Psychiatrists, this being about the College approach to transparency of potential competing interests]. Perhaps I did not word my question to Professor Sir Simon Wessely sufficiently clearly but this was the initial reply that I received:

From: Wessely, Simon
Sent: 08 June 2018 
To: Gordon, Peter J
Subject: Re: NICE Guideline - Depression in adults: treatment and management

Peter You have got me this time I have no idea what you are talking about Am not on and have never been on any NICE Guideline Committee

Simon

I therefore sent a further e-mail where I did my best to be as clear as possible, sharing the link to my recent post. I received this response:

From: Wessely, Simon 
Sent: 08 June 2018 
To: Gordon, Peter J
Subject: Re:  NICE Guideline - Depression in adults: treatment and management

A ah That letter Yes I signed a letter which is in the public domain because it was published in a newspaper
B I have never attended a meeting of any group I don’t have the time
C I don’t am afraid agree that if there was a group and if there was a meeting and if there were any minutes from that , that you have any right to see any of those, any more than you would have any rights to hear a transcript of a conversation I had yesterday with a bloke in the pub about some recent nice guideline and what we shoukd do about it. On the other hand any communications to nice are indeed FOI able as you know

Let’s not prolong this correspondence peter

I thanked Professor Sir Simon Wessely for this response and confirmed with him that as healthcare Guidelines are a matter of public interest that I intended to share his responses. Professor Sir Simon Wessely then replied to say that  “did [I] not understand” that this was “private chit-chat”. He signed-off his communication with “Sink” [I am not sure what was meant by this].

I am interested here only in the transparency of the process not the persons involved. The process of Guideline development should be fully open to the public. This is the basis of moral and ethical science.

 

 

4 Replies to “The development of healthcare Guidelines should be fully open”

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